The increasing prevalence of mental health issues presents a significant challenge for modern societies. There’s a crucial need for quick, affordable interventions that can be widely implemented by practitioners to support as many individuals as possible.

In this paper we aimed to investigate the mediating role of executive functions and emotional regulation in the relationship between sleep quality and physical activity, on one hand and negative affect, on the other.

Our proposed model is a serial mediation model, with executive functions as the first mediator and the two components of emotional regulation as the second mediator. We collected data from 286 participants who completed a series of questionnaires.

The initial model did nit fit the data well. Therefore, we added two paths: the direct relationship between sleep quality and negative affect and the direct relationship between executive functions and negative affect. The final model had a very good fit with the data. Thus, both the hypotheses regarding the direct relationships and those regarding the indirect relationships are supported by the data.

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The results highlight the importance of interventions aimed at improving sleep quality and promoting physical activity. These interventions can serve to promote optimal mental health in both clinical and non-clinical populations. Additionally, this research provides a basis for developing effective strategiesfor the prevention and treatment of these populations.

None Declared

Mental health reform was accepted in Slovenia in 2018 to provide accessible community treatment and care regionally for 40-70000 population. The implementation took place mostly with establishment of community mental health centers (CMHC), which included arround 20 000 patients in 16 community centers for the adult population. These CMHCs provide triage, needs assessment and treatment plans. The National Mental Health Plan did not adress the development of rehabilitation services. The institutional costs of treatment and care were not reduced, as well as not the number of institutional beds.

To assess the development of CMCH’s in Slovenia on the grounds of the data from the CMHC Logatec.

The data about 5761 patients included in the treatment process in one of the CMHCs were gathered regarding basic demographic data, diagnosis and treatment mode, including the definition of care coordination.

2654 patients were treated in the home environment. Medical nurses were coordinating treatment in the majority of these patients. Occupational therapist, social worker and psychiatrists were part of the team in this group. 816 patients in this group were diagnosed with dementia and had also somatic ilness. 1011 were diagnosed with schizoprenia or other psychotic disorders. 3107 patients were treated in the outpatient care, the majority of them by psychologists. Psychiatrists and social worker were included in these care coordinating teams. 1219 of them were diagnosed with depressive and 1001 anxiety disorders.

Community care teams in Slovenia included around 20 000 patients in three years time. The majority of these, specifically in Logatec are diagnosed with schizophrenia, dementia, depressive and anxiety disorders. Immediate access to service is still granted, with exception of psychological treatment which does not reach everybody in need in time. Development of CMCH’s should be led by needs assesment on the ground of developing data. It’s already obvious that increase of the number of psychologists to improve psychological assistance to people with cognitive decline and for young people in severe but mostly manageable psychological crisis is needed.

None Declared

Childhood trauma can significantly impact development, function, and well-being. Allied health professionals often support individuals exhibiting trauma-related signs, but the extent of trauma-informed care (TIC) understanding and application remains unclear. Moreover, secondary traumatic stress (STS) is a significant concern for professionals who treat traumatized children and youth. Thus, it is essential to provide TIC training to these professionals while also addressing the potential effects of STS.

The current study mapped the knowledge of trauma, the perceived relevance of TIC, and its implementation among allied health professionals working with children and youth. It also examined the relationships between knowledge of trauma, TIC perceived relevance and implementation, and relevant personal factors (resilience, self-compassion, and empathy).

176 allied health professionals (nutritionists and occupational, speech, and physical therapists) answered an online survey including a demographic questionnaire, Trauma-Informed Approach Questionnaire, Connor-Davidson Resilience Scale, Self-Compassion Scale, and Interpersonal Reactivity Index. Descriptive statistics and ANOVA were used to describe the sample and assess differences between knowledge, attitudes, and implementation. Pearson correlations were used to assess relationships with personal factors.

Significant differences were found between trauma knowledge, TIC relevance perception, and TIC implementation among the entire sample, F(2, 352) = 127.5, p<.001, η²= 0.43. Perception of TIC relevance was higher than knowledge of trauma (p<.001) and TIC implementation (p<.001). Positive correlations were found between resilience and knowledge of trauma (r=.22, p<.01), TIC perception relevance (r=.17, p<.05), and TIC implementation (r=.23, p<.05). Self-compassion was positively correlated with knowledge of trauma (r=.18, p<.05) and TIC implementation (r=.22, p<.01). Perspective-taking (empathy) was positively correlated with knowledge of trauma (r=.15, p<.05), perception of TIC relevance (r=.39, p<.01), and TIC implementation (r=.31, p<.01), and empathic concern was positively correlated with perception of TIC relevance (r=.33, p<.01).

The findings highlight the limited knowledge of trauma and TIC implementation among allied health professionals, emphasizing the lack of TIC training. Resilience, self-compassion, and empathy can be strategies to cope with treating children and youth who have experienced trauma and prevent STS.

None Declared

Prevention is key to maintain a healthy lifestyle and to ensure a positive outcome of any given condition, especially in such a vulnerable one, as is pregnancy. The progress made in prenatal care in the last century is astounding and professionals nowadays are able to provide state of the art investigations and inventions throughout pregnancy and even before, but there is a dire need to address the mental health approach of the soon-to-be mothers. Since studies have shown the link between mother’s emotions and the child’s well-being, providing support in order to maintain a good mental health status should be part of the prenatal care programmes.

The initial hypothesis is that pregnancy is a delicate period for the mother to be, therefore anxiety levels can be high or prenatal depressive episodes can occur in the absence of good psychological support. We aim to prove that integrating psychotherapy as part of the prenatal care programmes has benefits for both mothers and child and can significantly reduce the struggle of battling these symptoms on one’s own.

We launched an online questionnaire on groups and sites that targeted pregnant women or women who have just given birth. The questions were designed to address the anxiety and/or depressive symptoms throughout the pregnancy, the support they received from the health care providers and the impact these had on how they handled the pregnancy period. Anxiety symptoms were assessed using the HAM-A scale, meanwhile for depressive symptoms we used PHQ9 questionnaire. The study was conducted anonymously and was approved by the local ethics committee.

We received 200 answered questionnaire, from which 189 were valid and relevant to the study.

The results showed that the majority of pregnant women (83%) have struggled with anxiety and/or panic attack throughout the pregnancy and the prenatal care appointments proved insufficient to alleviate their concerns. Most of them (94%) turned to the internet for answers, which was an aggravating factor for the symptoms. The impact these symptoms had on their pregnancy varied from tensions between them and their partners, insomnia, feelings of worthlessness and irritability to moderate depressive episodes. Almost all the respondents (91%) have answers affirmatively to the proposal to undergo a few therapy sessions to manage these symptoms, if they were to be part of the prenatal care programme.

Pregnant women are at risk for various mental health issues which can be prevented with proper care, thus addressing further risk for both the mother and the baby. The need for integrating therapy in prenatal care programmes could have a great impact on the outcome of the pregnancy and even in women desire to bear children.

None Declared

Depression and anxiety are among the most prevalent mental health conditions, particularly in Western countries. Access to effective treatments, such as cognitive behavioral therapy (CBT), in publicly funded primary care settings is often insufficient.

This study aims to evaluate, within a non-inferiority framework, the effectiveness and cost-effectiveness of three treatment modalities for depression and anxiety within the Finnish public healthcare system: 1) a stepped care model, which involves sequential guided self-help (GSH) followed by face-to-face CBT for non-responders; 2) internet-delivered CBT (iCBT); and 3) face-to-face CBT.

Our objective is to recruit 948 adults (16+ yrs) exhibiting symptoms of depression (scoring ≥10 on the Patient Health Questionnaire, PHQ-9) and 948 adults exhibiting symptoms of anxiety (scoring ≥10 on the Generalized Anxiety Disorder scale, GAD-7). These participants should be suitable for step 1 or step 2 treatments, such as GSH, iCBT or CBT, within the Finnish public healthcare system. Individuals currently receiving psychological treatment, those with severe suicidal ideation, cognitive impairment, or those with substance abuse issues will be excluded from the study. Participants will be randomly assigned to one of three groups: GSH, iCBT, or face-to-face CBT. Those who do not respond adequately to GSH will be stepped up for further treatment with face-to-face CBT. Participants will complete symptom measures, such as PHQ-9, GAD-7, measures of function, work ability and social support at various stages over the course of the study to track changes in their mental health. The trial and follow-up period will span 5 years. In addition to data collected from the study participants, the study incorporates direct and indirect healthcare, social care, employment, and societal cost data from Finnish national registries. These registries will also be utilized to create population-matched controls for the study participants. The study will be conducted within several wellbeing service counties in Southern Finland and Western Finland. It is part of the Finnish First-Line Therapies –initiative in Finland’s public healthcare system.

Recruitment of study participants began in autumn 2024 and is expected to take approximately one year. Initial results are anticipated by 2026. The study protocol has been registered in the ISRCTN registry prior to the commencement of participant recruitment. The study is primarily funded by grants from the Ministry of Social Affairs and Health in Finland (VN/29619/2023 and VN/29613/2023).

The study aims to improve access to effective, evidence-based treatments for depression and anxiety within the public healthcare system.

None Declared

Depressive disorders among young people are a significant public health concern, particularly in underserved areas where access to mental health services is limited. The MAP-PSI model was developed to address this gap through a comprehensive approach that integrates promotion, prevention, and remote care strategies. Implemented in Ciudad Fernández, San Luis Potosí, Mexico, the model is designed to be adaptable and scalable, allowing it to meet the varying needs of different communities and leverage telemedicine and digital tools to extend mental health care.

The MAP-PSI model aims to improve mental health outcomes for young people by providing an adaptable framework for addressing depressive disorders. Its goals are to enhance accessibility to mental health services in underserved areas, utilize bilingual and culturally sensitive materials, and integrate actions across various community settings. The model seeks to empower healthcare providers and decision-makers to implement effective, sustainable interventions that can be adapted for other health issues and locations.

The MAP-PSI model is implemented in four phases:Exploration-Planning: This phase involves community engagement, conducting needs assessments, and training local staff to ensure that the intervention is tailored to the specific needs of the community. Initial and Total Implementation: Active monitoring and real-time adjustments are made to the model to ensure its effectiveness and responsiveness to emerging needs. Sustainability: Focuses on maintaining and expanding the model’s reach through continuous improvement processes, ensuring long-term impact and adaptation.

Key components of the model include psychoeducation, psychological support, telepsychiatry, and community-based promotion and prevention efforts. The use of bilingual and culturally sensitive materials is emphasized to cater to diverse populations, including indigenous groups. Integration across primary health care centers, schools, and community settings enhances the support for mental health and prevention of depressive disorders.

The MAP-PSI model demonstrates promising social returns on investment by effectively addressing depressive disorders through a scalable and adaptable framework. Its integration of telemedicine and digital tools enhances accessibility to mental health care in underserved areas, while its culturally sensitive approach ensures relevance across diverse populations. The model’s phased implementation framework supports both immediate effectiveness and long-term sustainability. The MAP-PSI model offers a valuable guide for health care providers and decision-makers, with the potential for adaptation and expansion to other health issues and regions, thereby contributing to improved mental health outcomes and sustainable intervention practices.

None Declared

Physical activity has been identified as a therapeutic intervention for the treatment of depressive disorders. It can be conducted as a standalone intervention or as a complementary therapy method within a multimodal treatment framework. Engaging in physical activity is important for maintaining physical and mental health. There is a need for research on the implementation of exercise therapy interventions that takes into account everyday clinical practice outside the controlled conditions in study protocols. Physical activity is particularly promoted in the context of sports therapy.

Therefore, the objective of this study is to examine the impact of exercise therapy in a day clinic setting on depressive symptom severity and cardiovascular fitness.

The study sample includes patients with a primary diagnosis of depression who had completed a minimum of four and a maximum of nine weeks of inpatient treatment in a psychotherapeutic and psychosomatic hospital in Germany. Patients in the intervention group (IG) receive exercise therapy at least twice a week throughout their treatment, while patients in the control group received a maximum of 0.5 units/week of exercise therapy. As part of the multimodal treatment setting, the exercise therapy interventions in both groups include spinal exercises, equipment-based strength and endurance training, soccer and table tennis. The BDI-II is administered to both groups to assess the severity of depressive symptoms. Cardiovascular fitness of IG is monitored using a submaximal cycle ergometer aerobic fitness test (PWC test) at baseline and at the end of treatment.

The total number of patients included in the analysis was n=37 in IG (male=78%, M age=42.05) and n=20 in CG (male=60%, M age=47,35). A significant reduction in the BDI-II score was observed in both the IG (M ΔBDI-II=-16.0, p<.001) and CG (M ΔBDI-II=-8.0, p<.05) from the beginning to the end of the treatment period. When comparing reduction in depressive symptoms between two groups, IG achieved statistically significant greater reduction in depressive symptoms compared to the CG (M ΔBDI-II=-8.0, p<.01). Participants in the IG showed a statistically significant improvement in performance, with an increase of 7 watts for the PWC130 and 12 watts for the PWC150 (p<.05), as measured by the submaximal cycle ergometer aerobic fitness test throughout treatment.

The integration of exercise therapy into a multimodal treatment framework was observed to positively impact both physical and mental health outcomes. Given the presence of physical comorbidities and relapses, further research should investigate the long-term impact of behavioral changes related to physically active lifestyle.

None Declared

Treatment-resistant depression (TRD) is a condition associated with multiple severe implications and high suicide risk. Esketamine is a pharmacological agent approved by the FDA and EMA recommended for adults diagnosed with TRD. The glutamatergic mechanisms of depression are currently the subject of numerous studies. Esketamine has glutamatergic neuromodulatory properties to enhance the effects of selective serotonin and norepinephrine reuptake inhibitors. Furthermore, the anti-suicidal effect of esketamine represents a reason to explore its properties since managing suicide risk in patients with MDD is complex.

The present observational, retrospective study aimed to assess the efficacy and tolerability of Esketamine in a real-world outpatient setting. A secondary objective was to explore the potential benefits on hopelessness and suicide risk(suicide ideation and suicide attempts) to establish future research directions that may enrich knowledge on the effects of esketamine on suicide risk in patients with resistant depression.

20 patients diagnosed with treatment-resistant depression disorder were treated with Esketamine.Depressive symptoms (MADRS and BDI), suicide risk(C-SSRS), and hopelessness(BHS)were assessed. Repeated measures analyses were conducted to evaluate changes from baseline(T0) and 3-month follow-up(T1).

11 patients(60%)were females, and the average age of the sample was 49.40 (SD= 17.38). 9 patients(45%)were single,and 11 patients (55%) were employees.At baseline,11 patients(55%)reported suicidal ideation,and 2 patients(10%)attempted suicide in the previous 3 months. Of the 20 patients, 4 patients did not complete the treatment and were excluded from analyses. Results showed that depressive symptoms decreased at the end of treatment (t1) compared to baseline (t0).Specifically,both clinician (t=7.32;p<.001) and self-report (t=4.34;p<.001)measures show lower levels of depressive symptoms(MADRS t0=33.31±4.35vs.t1= 20.13±5.31,and BDI t0=42.13±7.97 vs.t1=29.31±9.96, respectively).About suicide risk, at baseline 11 patients reported some level of suicidal ideation while at (T1) 7 patients did; the difference was not statistically significant(p=.125);conversely,a significant decrease in suicidal ideation intensity was found (t=2.48,p<.05; t0=5.37±5.77vs.t1=1.87±3.51). Finally,patients also reported decreased hopelessness levels(BHS;t=3.97,p=.001; t0=16.19±3.12 vs. t1=12.12±4.27).

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Our findings demonstrated a robust overall response regarding depressive symptoms after Esketamine in TRD. A notable response concerning suicide ideation intensity was also observed in patients with resistant depression; however, further studies are necessary to better investigate the role of esketamine in suicide prevention.

M. Pompili Consultant of: M Pompili wishes to disclose that in the last five years, he has received lectures and advisory board honoraria or has engaged in clinical trial activities with Angelini Pharma, Allergan, Janssen, Lundbeck, Merck Sharp and Dohme, Otsuka, Rovi, Pfizer, Fidia, Viatris, Recordati,Boehringer Ingelheim and Teva, M. A. Trocchia: None Declared, L. Longhini: None Declared, E. Dispenza: None Declared, C. Di Legge: None Declared, S. Sarubbi: None Declared, D. Erbuto: None Declared, I. Berardelli: None Declared

Suicide is a major public health concern, especially among older adults. Early identification of individuals at risk of suicide is crucial for early intervention, which significantly improves prevention efforts. Early identification of individuals at risk of suicide is crucial for prevention.

This study aimed to develop a model for predicting suicidal ideation in community-based older adults using deep phenotype data with machine learning classifiers.

A study investigating suicidal ideation in community-based older adults utilized a mobile assessment bus to collect data from 358 participants. Deep phenotype data, including Patient Health Questionnaire-9 (PHQ), Generalized Anxiety Disorder-7 (GAD), World Health Organization Quality of Life (WHOQOL), Perceived Stress Scale-10 (PSS) questionnaires, and 32-channel EEG recordings using the 10/20 system, were acquired. Of these participants, 238 completed all assessments. Suicidal ideation was defined by a score of 1 or higher on the ninth question of the PHQ-9. Data from both groups were compared, and features with an effect size of 1 or greater (Cohen’s D) were selected for further analysis. Cohen’s D. Machine-learning classifiers, including Support Vector Machine (SVM), Random Forest (RF), and Linear Discriminant Analysis (LDA) were employed to predict suicidal ideation using a 7:3 training-test split repeated 100 times to obtain performance metrics.

Scores on the PHQ, GAD, and WHOQOL scales differed significantly, while the PSS data showed variations in all items except one between the group with suicidal ideation and the group without. Notably, analysis of the EEG data from eight brain regions identified disparities in 108 out of 248 features. Among all data, ten features with Cohen’s D values exceeding 1 were identified, primarily consisting of questions directly related to themes of negative emotions. Using these features, the classification model achieved an AUC of 0.8913, demonstrating strong predictive performance for suicidal ideation.

Our findings demonstrate the potential of deep phenotyping, even in community-based settings, to predict suicidal ideation in older adults. These insights can inform the development of suicide intervention systems. Additionally, refining predictive models to encompass broader mental health symptoms could solidify deep phenotyping as a crucial tool for early intervention in public healthcare.

None Declared

Major depressive disorder (MDD) is the leading cause of disability worldwide. About one third of patients with MDD fails to achieve remission despite treatment and can be considered as Treatment-Resistant patients. Esketamine nasal spray (ESK) is indicated since 2019 in US and Europe for adults with Treatment-Resistant Depression (TRD), who have not responded to at least two different treatments with antidepressants in the current moderate to severe depressive episode. ELLIPSE is the first prospective observational study on ESK in real world conditions in France.

The aim of the study is to describe the profile of all patients treated with ESK in real-world clinical practice, the modalities of the use of ESK, the patient management at the site of care and the efficacy and safety outcomes during 12 months after ESK treatment initiation for MDD patients.

ELLIPSE is a French prospective, multicenter, non-interventional study designed to describe patients presenting MDD treated with ESK, and for whom the decision to prescribe ESK is independent of the study. Data were collected from physicians as part of routine clinical practice and from patients via self-questionnaires.

Thirty-one sites have included 211 MDD patients treated with ESK. The analysis will describe patient profiles (sociodemographic and disease characteristics, medical history, comorbidities), use of ESK at initiation and during study (reason for initiation, posology, frequency, administration, surveillance, treatment duration), safety profile (percentage of reported adverse events) and efficacy (MADRS response and remission rates over 12 months). The study results will be available in January 2025 and will be detailed in the poster presented at the conference.

ELLIPSE is the first large prospective French study providing real world evidence on patients treated with ESK, including patient’s profile, condition of use of ESK treatment and follow-up efficacy and safety data. This study should confirm that ESK has its place in therapy for the treatment of MDD.

P.-M. Llorca Consultant of: Abbvie, Boehringer-Ingelheim, Eisai, Ethypharm, HAC, Janssen, Karla Therapeutics, Lilly, Lundbeck, MSD, Neuraxpharm, Newron, Novartis, Otsuka, Roche, Sanofi, Teva. He provided expert testimony for Janssen, Otsuka., L. Mékaoui Consultant of: Janssen, M. Rotharmel Consultant of: Janssen, P. de Maricourt Consultant of: Janssen, C. Wicart Employee of: Janssen, E. Gaudre-Wattinne Employee of: Janssen, J. Dupin Employee of: Janssen.

Depressive disorders often require specialised psychiatric services. Timely, appropriate medication initiation and/or change plays a crucial role in improving patient (pt) outcomes (Kraus et al. Transl Psychiatry 2019;9 127).

Describe the type of, and time to, medication changes within 12 months of the initial assessment of pts with depression recorded by specialised psychiatric care (SPC).

This cohort study leveraged Finnish pt data from 19 registries from 2014–2020. Adult pts with a depression diagnosis recorded by SPC in the Helsinki and Uusimaa region in 2015 (with no depression diagnosis given by SPC within the previous year) were included. All treatments were recorded as monotherapy or combination/augmentation therapy. The Kaplan-Meier method was used to analyse time to treatment change (TTC).

9305 pts were included; baseline characteristics are reported (Table 1). There was no change to the baseline treatment status in 39.7% of pts (Table 2). The most common change was from no medication to monotherapy (2138 pts [45.6% of those with no treatment before]). 2202 (23.7%) pts remained untreated throughout the study. Median (95% confidence interval) TTC following the initial assessment by SPC was 53 (50–56) days (Figure 1).

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Around 40% of pts referred to SPC had no prior pharmacotherapy. Monotherapy was the most common treatment provided. Almost 40% of pts had no change in their baseline treatment over 12 months, highlighting the need for further research to optimise care.

None Declared

Major Depressive Disorder (MDD) is a pervasive global health issue, contributing significantly to disability and impaired quality of life. A substantial proportion of individuals with MDD develop Treatment-Resistant Depression (TRD), characterised by the failure to respond to at least two adequate antidepressant treatments (at an adequate dose and duration). TRD poses additional challenges due to its complex clinical presentation and limited treatment options, making it crucial to better understand its impact and develop more effective care strategies.

To investigate the prevalence and clinical profiles of TRD in a large NHS Mental Health Trust and explore the treatment experiences and perceptions of TRD patients and healthcare professionals (HCPs) involved in their care.

A concurrent mixed-methods approach, incorporating patient and public involvement (PPIE), was used. Quantitative analysis of anonymised electronic health records (EHRs) identified the TRD cohort and key characteristics (e.g. age, gender, employment status). Binary logistic regression explored predictors such as comorbidities and service use. The qualitative component included semi-structured interviews with TRD patients (n=7) and HCPs (n=8), analysed using thematic analysis to explore lived experiences and treatment barriers. Findings from both approaches were integrated to provide a comprehensive understanding of TRD.

TRD was prevalent in 48% of patients diagnosed with MDD. Predictors of TRD included recurrent depression (OR=1.24, CI 95%=1.05–1.45), comorbid anxiety (OR=1.21, CI 95%=1.03–1.41), personality disorders (OR=1.35, CI 95%=1.10–1.65), and cardiovascular diseases (OR=1.46, CI 95%=1.02–2.07). Qualitative findings highlighted the severe emotional impact of TRD on patients’ lives and revealed significant dissatisfaction with treatment options, particularly frustration with the “trial and error” approach of pharmacological treatments. HCPs echoed concerns about the lack of standardised treatment pathways, with both groups emphasising the need for more holistic and personalised care, citing limited access as a serious barrier to effective treatment.

This study highlights the significant burden of TRD, affecting nearly half of MDD patients within the examined NHS Trust. By combining quantitative and qualitative methods, it offers a comprehensive understanding of TRD’s prevalence and complexities. The findings support a shift toward holistic, patient-centred care, addressing institutional barriers and enhancing healthcare provider resources to improve outcomes.

None Declared

Depression significantly impacts quality of life, and the growing global mental health burden necessitates effective strategies for early detection. Traditional diagnostic methods often involve clinician-led interviews and assessments, which can be time-consuming and may not always be accessible to individuals in underserved or remote areas. As a result, self-assessment scales have emerged as a valuable tool for initial depression screening, offering a cost-effective and timely alternative that empowers individuals to monitor their mental health independently.

Recent trends in self-assessment tools for depression highlight the development of digital platforms, such as smartphone apps and web-based applications, which allow for greater reach and real-time data collection.

The primary objective of this study is to systematically review recent trends in the development and use of self-assessment scales for depression screening. With the growing global prevalence of depression and the necessity for early detection, self-assessment tools have become a widely adopted method for screening, offering the advantage of accessibility, cost-effectiveness, and user autonomy. This study aims to evaluate these tools in terms of their psychometric properties, including reliability, validity, and sensitivity, which are crucial for ensuring accurate and dependable depression detection.

A systematic review methodology was employed, focusing on studies published between 2015 and 2024. The sample included 40 peer-reviewed articles sourced from academic databases, with studies chosen based on their relevance to self-assessment depression screening tools. The sampling strategy involved selecting scales used in diverse settings, including clinical environments, schools, and online platforms. Key tools such as the Patient Health Questionnaire (PHQ-9), Beck Depression Inventory (BDI), and the Depression Anxiety Stress Scales (DASS-21) were analyzed.

Results indicated an increase in the utilization of digital and app-based self-assessment tools, with advancements in adaptive testing and machine learning-based algorithms improving the accuracy and sensitivity of depression screening. Additionally, the results showed promising psychometric reliability and validity across different cultural contexts. However, the study also highlights challenges, including the potential for over-reliance on self-reporting and the underrepresentation of marginalized populations in the development of these tools.

Despite the significant advancements in self-assessment scales for depression screening, challenges remain in ensuring that these tools are both equitable and inclusive. One critical area for future research involves addressing cultural and demographic biases that may limit the effectiveness of these scales in diverse populations.

None Declared

An increasing number of patients with treatment-resistant depression (TRD) are treated with a novel form of transcranial magnetic stimulation (TMS): the intermittent theta burst stimulation (iTBS). In this retrospective naturalistic study, we analyzed the outcome of iTBS treatment in patients with treatment-resistant depression.

To investigate the impact of history of esketamine treatment in the current depressive episode on response to iTBS.

In this study, we included 66 hospitalized patients (57.6% female; mean age, 52.7 years) from the University Department of Psychiatry, University of Münster. Prior to iTBS treatment, 10 patients were treated with esketamine (60% female; average age, 49.8 years) and 56 were not (57% female; average age, 53.25 years). A Chi-squared test was utilized to investigate the impact of history of esketamine treatment on response to iTBS.

The overall response rate was 51.5%. Prior to iTBS, 15% of the patients were treated with esketamine in the current episode. In the patient group with history of esketamine treatment (ESK+), 40% of the patients responded to iTBS. In the patients without history of esketamine treatment (ESK-) in the current episode, the response rate to iTBS was 53.6 %. However, history of esketamine treatment in the current episode had no significant impact on iTBS outcome (P = 0.505; χ2 = 0,626; df = 1). The difference in baseline disease severity between the groups was not statistically significant (CGI-S 6.3 (ESK+) vs 6.1 (ESK-), P = 0.281; F = 1.184; df = 64). The total rate of treatment dropouts was 3%.

History of esketamine treatment in the current episode was associated with worse outcome of iTBS. This finding was not statistically significant. iTBS may be an effective (40% response rate) and safe treatment for patients who did not respond to esketamine therapy.

M. Tonkul: None Declared, B. Baune Consultant of: Received speaker/consultation fees from AstraZeneca, Lundbeck, Pfizer, Takeda, Servier, Bristol Myers Squibb, Otsuka, LivaNova, Biogen, Angelini, and Janssen-Cilag., E. Kavakbasi Consultant of: Received speaker and advisor honoraria from LivaNova and Janssen-Cilag.

The DiSCoVeR trial (The DiSCoVeR Project: Examining the synergistic effects of a cognitive control videogame and a self-administered non-invasive brain stimulation on alleviating depression) is a double-blind, sham controlled, randomized controlled trial (RCT) investigating the feasibility and efficacy of an innovative, self-applied treatment approach for patients diagnosed with major depressive disorder (MDD). The multi-site trial is conducted at three clinical trial sites (Hadassah, Israel; Riga Stradiņš University, Latvia; Ludwig-Maximilian-University, Germany). During the first study visit of this trial data on different patient baseline parameters were gathered including assesment of depressive symptoms, anxiety symptoms and rumination.

The aim of this abstract is to examine the relationship between depression, rumination and anxiety in this patient sample. Rumination, often characterized by repetitive, negative thinking, can exacerbate symptoms of anxiety and depression by maintaining and intensifying negative emotional states. This cycle creates a challenging clinical problem making it difficult to break free without targeted interventions.

This analysis includes baseline data from 106 MDD patients enrolled in the DiSCoVeR trial as of April 2024. Depression severity was assessed using the Montgomery–Åsberg Depression Rating Scale (MADRS), anxiety symptoms were measured using the Generalized Anxiety Disorder Questionnaire (GAD-7), and rumination was evaluated with the Ruminative Response Scale (RRS). Data were analyzed using the Jamovi statistical platform, applying linear regression model to explore the relationship between depression, rumination, and anxiety. All assumptions for linear regression were met prior to analysis.

The mean age of the participants in this study sample ranged from 18 to 63 years old (mean age 33.4 years). 65.7% of the participants were female. Regression analysis revealed a significant positive association between anxiety (GAD-7) and rumination (RRS), suggesting that increased anxiety symptoms are associated with higher levels of rumination (p < .001). However, age and gender were not significant predictors of rumination. While depression (MADRS) was moderately associated with rumination, this effect was not statistically significant. Educational level showed a marginal effect, with university-educated individuals showing higher rumination levels compared to those with professional education.

In this patient sample overall, anxiety (GAD-7 score) was the strongest predictor of rumination, while other factors such as depression, age, and gender did not show significant effects. Education level might have a marginal impact, especially for individuals with university education.

None Declared

Physical activity can be therapeutically effective in the treatment of depressive disorders. There is a need for research in clinical practice both with regard to the framework conditions required for physical activity and whether the implementation of sports therapy under the conditions of everyday care can have an effect on physical fitness and depressive symptoms. This study therefore examines the effect of sports and exercise therapy in the day-care treatment of unipolar depression.

• - treatment of depressive disorders

• - implementation of sports therapy under the conditions of everyday care

Patients with a depressive disorder as their main clinical diagnosis (F32./F33.) who underwent day clinic treatment for 5-11 weeks were included. People in the intervention and control groups completed a minimum of 2.0 and a maximum of 0.5 exercise sessions per week respectively. To investigate the effect of sports and exercise therapy on aerobic performance, the intervention group completed a submaximal, bicycle ergometric step test (PWC test), whereby the heart rate was measured over the individual exercise levels in a pre-post comparison. Furthermore, the change in depression symptoms between the intervention and control group was recorded at admission and discharge from treatment using the BDI-II.

Patients in the intervention group (IG) showed a significantly greater reduction in depression symptoms compared to the control group (CG) (ΔBDI-II; M = - 8, p <.01).

In the pre-post comparison of PWC, IG achieved a significant increase in performance of 7 and 12 watts respectively (p <.05; t-test). Further inferential statistical results are reported.

Regular physical training can lead to a significant improvement in endurance performance and an improvement in depressive symptoms.

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Obesity is a growing problem in several developed countries and has a complex etiology in teenagers. Approximately one-third of children and adolescents in the United States are overweight or obese. However, it is not clear how depression and obesity are screened and treated in the primary care setting for adolescents.

This study aims to describe the prevalence, screening, and treatment rates for depression in adolescents in ambulatory settings in the United States.

Data on 444,080,295 male and female adolescents ages 13-18 were extracted from the 2008-2018 CDC National Ambulatory Medical Care Survey datasets. Adolescents were stratified by weight groups based on CDC guidelines (i.e., body mass index percentile).

Of the adolescents, 16.89% were obese, 13.81% were overweight, 43.39% were normal weight, and 25.91% were underweight. Depression screening rates in adolescents with obesity is 2.89%, overweight is 3.35%, normal weight 3.49%, and underweight is 2.83% (p=0.382). Prevalence of depression in adolescents with obesity is 7.17%, overweight is 6.04%, normal weight is 6.31%, and underweight is 12.14% (p<0.0001). Prevalence of counseling and psychotherapy in adolescents with obese status is 2.70%, overweight status is 2.89%, normal weight is 2.92%, and underweight is 11.27% (p<0.0001). Patients seen by primary care health workers, age, female gender, number of chronic conditions, and increased visits are significant predictors of depression diagnosis in adolescents.

Depression in adolescents who are overweight or obese is under-screened for, under-identified, and under-treated. More mental health counseling and psychotherapy must be offered to those with both depression and obesity.

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Perinatal depression (PND) is characterized by depressive episodes with an onset during pregnancy or following delivery. The clinical management of PND is however challenging because patients are often concerned of the potential harm of pharmaceutical therapy on foetus via placenta or breastfeeding. Previous findings have shown that women with a family history of psychiatric disorders (FhPsy) are at high risk for PND. However, no precision prevention strategy has been developed for this high-risk population.

To identify risk factors modifying the risk of perinatal depression (PND) among women with a family history of psychiatric disorders (FhPsy).

We conducted a cohort study of 2,195,838 pregnancies of which 1,236,980 births between 2001-2021 in Sweden. PND was defined as a depression diagnosed, or antidepressant prescribed during pregnancy or within a year postpartum. FhPsy was assessed as any psychiatric disorder diagnosed before pregnancy among biological parents/siblings. Modifiable risk factors, i.e., snuff use and smoking before and during pregnancy, and BMI in early pregnancy and at delivery, were identified from registers. Multivariable logistic regression was used to estimate the OR of PND in relation to FhPsy, modifiable risk factors, and interaction effects.

In total, 94,597 (4.35%) women were diagnosed with PND at a mean age of 31.24 (SD = 5.30) years. Women with a FhPsy had 2.6 higher risk of PND (95% CI 2.58-2.61). All modifiable risk factors were also positive associated with PND (ORs ranged from 0.79 - 2.34). Interaction effects were observed between FhPsy and the modifiable factors (P-for-interaction <0.05). Specifically, women with FhPsy using snuff three months prior to pregnancy had 3.54 times higher odds of PND (95% CI 3.54-3.78), compared with women without such history who were non-snuff users. However, the OR was attenuated by 61% among those with FhPsy yet no use of snuff (OR 2.19, 95% CI 2.17-2.23). Similar trends were found for heavy-smoking-to-no-smoking either before or during early pregnancy and for obesity-to-normal-weight either during early pregnancy or at delivery among women with FhPsy, with an OR attenuation ranging from 11% to 58%.

While women with a FhPsy are at risk for PND, modifying risk factors, i.e., smoking or snuff cessation and maintaining a healthy weight, may help lower such odds. Our findings have important implications for informing prevention strategies targeting the high-risk population.

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Major depressive disorder is a global mental health challenge imposing a serious burden on individuals and society. Treatment resistant depression (TRD) is most commonly defined as inadequate treatment response following at least two consecutive antidepressant trials of adequate dose, duration and treatment adherence. TRD is associated with high personal suffering, considerable functional impairment and significant mental health costs.

This study investigated the rate of TRD in treatment-seeking outpatients with major depressive disorder and clinically-related variables. We hypothesized that patients with TRD would have more severe symptoms, chronic course and more hospitalization than patients without TRD.

The files of patients diagnosed with Major Depressive Disorder who had applied to the Outpatient Psychiatry within the last 3 months and had a follow-up history of at least 1 year were reviewed (n=204). Demographic and clinical data of the patients were recorded using a structured data form. Dutch Measure for quantification of Treatment Resistance in depression (DM-TRD) scores were calculated. The study was approved by the Akdeniz University Ethics Committee (approval date:22/8/2024).

Regarding the index episode, the majority of patients had received selective-serotonin reuptake inhibitor (SSRI) treatment (22% escitalopram, 14.2% sertraline). 30.9% of the patients had received augmentation. After the first treatment trial, 21.1% of the patients had treatment-response, and 30.7% achieved remission. After the second treatment trial, 10.5% showed treatment-response, and 16.3% achieved remission. The proportion of patients meeting the criteria for TRD was 29.9%.

When comparing patients with TRD, the total number of depressive episodes was significantly lower (p=0.01), the duration from the onset of the index episode to treatment and recovery was longer (p<0.001, p=0.02; respectively) in those with TRD. The number of ECT episodes and rTMS sessions was higher (p<0.001, p=0.004; respectively), the DM-TRD score, the frequency of benzodiazepine use and the rate of inpatient treatment were also higher (p<0.001, p<0.001, p=0.01; respectively). The rate of non-adherence to treatment, the rate of chronic episodes and symptom severity were higher, functional impairment was more severe, and the frequency of comorbid personality disorders was higher (p<0.001, all).

To the best of our knowledge, this is the first study reporting TRD data from Türkiye. Our results showed that patients with TRD had more chronic and less repetitive illness course, duration of untreated depressive symptoms were longer, use of benzodiazepine, ECT and rTMS treatments were more frequent and longer than patients without TRD. These results should alert clinicians about subprofiles of patients with TRD to predict course and develop preventive effective strategies.

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Treatment-resistant depression is particularly challenging in individuals with a history of suicide, often associated with lower rates of remission. The antidepressant efficacy of Acceptance and Commitment Therapy (ACT) in individuals with a history of suicide has been demonstrated (Zhao B, et al. Ann Gen Psychiatry 2023;22:34). It is crucial to further understand the underlying mechanisms driving this therapeutic effect.

To investigate cerebral biomarkers of therapeutic response to Acceptance and Commitment Therapy (ACT) versus Progressive Relaxation Therapy (PRT) in depression and suicidal risk.

This randomized controlled trial included 32 patients with a history of suicide attempts in the past year who underwent seven weekly sessions of ACT or PRT. They completed clinical and MRI examinations (resting state, diffusion tensor, cerebral blood flow measured by pCASL, and anatomical sessions) at baseline and after therapy completion. Resting-state functional changes (graph theory, functional connectivity) in two networks identified in previous depression studies (Zhang X, Xu R, Ma H, et al. Biol Psychiatry 2024;95:1091-1099), according to the Schaefer atlas, were measured between groups and in the entire sample. A Principal Component Analysis (PCA) was conducted to combine depression, hopelessness, and psychological pain into a single composite variable, explaining 77.8% of the variance with strong correlations to the original variables: r = .91. This Depression Component (DC) was used in further analyses.

The patients were predominantly women (87.5%) with a mean age of 40 years (SD = 12). 81% of patients experienced current depression. No significant Group x Time interaction was found. In the whole sample, no anatomy nor diffusion tensor metrics modification has been found. However, the reduction of the DC was negatively correlated with modularity (r = -0.476, pFDR < 0.05) for the Salience Ventral Attentional. Moreover, within this network the DC variable was negatively correlated with the cerebral blood flow of one region (r = -0.5, pFDR < 0.05) and positively correlated with functional connectivity (T = 4.72, pFDR < 0.05) (Figure 1).

Image 1:

These results suggest that the therapeutic response, and consequently the reduction of the depression component, might be related to a reorganization within the salience network. Modularity refers to how well a brain network is organized into distinct groups or clusters, where connections within each group are stronger than those between different groups. We observed increased modularity and cerebral blood flow within the salience ventral attentional network, which could reflect a more specialized and segregated functional organization. This reorganization could enhance the brain’s ability to regulate emotional and cognitive processes, supporting recovery from depression.

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